Carelon

https://www.carelonglobal.com/

About

Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system. Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health. CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers. What’s unique about Carelon Global Solutions (CGS)? - Our clinical and operational expertise can meet the needs of health plans of any size. - Our 25,000+ strong diverse, multi-cultural team is equipped with deep experience in the health insurance and operational processes space. - We have access to the collective experience and expertise of a large healthcare organization and are able to bolster it with the agility and adaptability of a start-up. - We deliver cohesive, integrated and end-to-end experiences that advance whole-person health by leveraging intuitive quality controls, metrics-driven governance and exceptional customer service. Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective and efficient.

Active Jobs

38 Jobs

Recent jobs

Fresher - Claims Associate Junior

Carelon

Gurgaon, Haryana, India

Posted: 22 days ago

Position Title: Fresher - Claims Associate Junior - JR117995 Job Description: Job Title Junior Associate Claims Requirement Type Full-Time Employee Job Location Gurugram Requirement Level Junior Associate - Claims Hiring Manager Team Lead, Business Operations Primary Skill Business Operations Claims Business Business Operations Skill Category Generic   JOB POSITION   Carelon Global Solutions India is seeking a highly creative and meticulous Associate - Claims, who will be responsible for all Processing level delivery & performance as per set SLA parameters.  The incumbent will report to Team Lead – Business operations and must understand the business delivery, present and metrics with leadership; brief and deliver all in-house process delivery & requirements, apart from coordinating with onshore partners as and when required.   JOB RESPONSIBILITY   Junior Associate – Claims(Business Operations) will be responsible for the following: Evaluates and processes claims in accordance with company policies and procedures, as well as to productivity and quality standards. Consistently maintains production and quality standards based on quality control expectations. Adaptability in cross training and multiple tasking. Responsible for the accurate and timely processing of claims. Assists claimants, providers, and clients with problems or questions regarding their claims and/or policies. Flexible to work in any shift & in office premises per set organizational/Business requirements.   QUALIFICATION Bachelors’ or Masters’ degree in fine arts/ design Non-BTech (preferably)   EXPERIENCE Freshers   SKILLS AND COMPETENCIES Basic Computer and keyboard Skills - nice to have Good oral and written communication skills Working knowledge of MS Office Strong customer service orientation Agile & Solution centric Inclusive Flexible to work in any shifts/Work from office

Reporting Specialist

Carelon

Taguig, Metro Manila, Philippines

Posted: a year ago

JOB DESCRIPTION Responsible for preparing and ensuring accuracy of reports on operational data and metrics. Primary duties may include, but are not limited to: Conducts research required to verify report accuracy. Manipulates and enters data to prepare required reports. Ensures relevance and accuracy of reporting. Requires a H.S. diploma or equivalent and 1-3 years related experience; or any combination of education and experience, which would provide an equivalent background. Written and oral communication skills required. Good PC office software and keyboard skills required.

Assistant Manager

Carelon

Taguig, Metro Manila, Philippines

Posted: a year ago

JOB DESCRIPTION Responsible for serving as the operations point of contact in for day to day operations, including but not limited to, facilitating issue resolution, meeting goals and targets Primary duties may include, but are not limited to: Conducts Performance reviews and participates in performance management initiatives. Acts as a liaison for both internal and external groups for program initiatives. Contributes in creating, launching and driving critical account initiatives and programs. Provides inputs to policies and processes impacting the operations. Manages a team of CCR’s in the optimal execution of operations activities ensuring that each team member meets / exceeds their goals and metrics on a daily, weekly and monthly basis. Coordinates with workforce for staffing requirements and scheduling of agents given leaves, absences and attrition.   Arranges schedules to meet the service metrics by efficiently handling the forecast and / or spikes in call. Hires, trains, coaches, counsels, and evaluates performance of direct reports. Requires a BA/BS; 5 years of related experience in a call center environment; or any combination of education and experience, which would provide an equivalent background.

Mgr Customer Care

Carelon

Iloilo, Antique, Philippines

Posted: a year ago

JOB DESCRIPTION Responsible for providing oversight for customer service staff. Responsible for establishing departmental policies and procedures. Primary duties may include, but are not limited to: Directs implementation and administration of benefit programs. Prepares and communicates information to appropriate parties regarding benefit programs, procedures, changes and government mandated disclosures. Audits to monitor efficiency and compliance with policies; prepares specialized reports; may be assigned to special project work consistent with the role and dictated by the needs of the business. Hires, trains, coaches, counsels, and evaluates performance of direct reports; Requires BA/BS; 3 years of experience in a leadership role and 5 years related customer service experience, or any combination of education and experience, which would provide an equivalent background.

Customer Care Rep I

Carelon

Taguig, Metro Manila, Philippines

Posted: a year ago

Responsible for customer inquiries regarding insurance benefits, claims, and more. Requires basic training completion, PC skills, and positive customer relations. Role includes data analysis, troubleshooting, and meeting department goals. On-site full-time opportunity at Carelon in Taguig, Metro Manila, Philippines.

Operation's Manager for Contact Center

Carelon

Taguig, Metro Manila, Philippines

Posted: a year ago

JOB DESCRIPTION Description Responsible for providing oversight for customer service staff. Responsible for establishing departmental policies and procedures.  Primary duties may include but are not limited to: Directs implementation and administration of benefit programs. Prepares and communicates information to appropriate parties regarding benefit programs, procedures, changes, and government mandated disclosures. Audits to monitor efficiency and compliance with policies; prepares specialized reports; may be assigned to special project work consistent with the role and dictated by the needs of the business. Hires, trains, coaches, counsels, and evaluates performance of direct reports.  Requires BA/BS; 1 year of experience in a leadership role and 5 years related customer service experience, or any combination of education and experience, which would provide an equivalent background.